The Robert Brigham Multidisciplinary Clinical Research Center (RBMCRC) is the principal resource for clinical, translational, epidemiological, health services and methodological research on rheumatologic and musculoskeletal conditions at the Brigham and Women's Hospital and throughout the Harvard Medical and Public Health communities. The Center is a hub for clinically- and policy-relevant, methodologically rigorous, interdisciplinary research to improve the outcomes of patients with musculoskeletal and rheumatologic disorders. The objectives of the Center are to: 1) Perform cutting edge research on rheumatologic and musculoskeletal problems in order to prevent these disorders, improve their management, enhance quality of life for patients with these problems and optimize provision of services for patients with rheumatic and musculoskeletal disorders. 2) Provide core methodologic and administrative resources and scientific leadership to catalyze such research among Center investigators and throughout the Center's research base. 3) Enhance the career development of younger investigators dedicated to the application of rigorous clinical research methodology to problems affecting the quality of life of persons with rheumatic and musculoskeletal disorders. The Center is structured around a Methodology Core, which ensures rigorous design and execution of research, and an Administrative Core, which provides effective scientific leadership, financial management and oversight. The Center proposes three projects: 1) Suboptimal outcomes of total knee replacement: Phenotypes and Risk factors; 2) Rheumatic expertise expanded access to improve community health; and, 3) Communication of biomarker, genetic and lifestyle risk factor profiles for RA to first degree relatives. Each ofthe projects applies rigorous methods to address pressing priorities in rheumatic and musculoskeletal disease: optimizing outcomes of total knee replacement, a procedure performed on more than 600,000 Americans each year; ensuring that primary care physicians and rheumatologist collaborate effectively to provide appropriate medications to patients with rheumatoid arthritis (RA); and anticipating the emergence of RA prevention by developing methods to communicate RA risk and preventive behavioral strategies to first degree relatives of persons with rheumatoid arthritis.